Tibbs R E, Harkey H L, Raila F A
Department of Neurosurgery, University of Mississippi Hospitals and Clinics, Jackson 39216, USA.
Neurosurgery. 1999 Jan;44(1):221-3. doi: 10.1097/00006123-199901000-00137.
Tumors of the cauda equina and specifically the filum terminale are uncommon. We report the fourth case of a hemangioblastoma occurring in the filum terminale.
This 35-year-old man presented with a 4-year history of low back pain that had been previously diagnosed as a bulging disc and exhibited severe pain in response to percussion of his lower back but was neurologically intact. He was found to have a large, enhancing mass filling the thecal sac at L2-L3.
The tumor was found to be attached to the filum terminale and was cleanly dissected off en toto. Microscopically, the mass consisted of endothelial cells in addition to abundant fat-laden stromal cells and reticulum.
We present a case report and a review of the literature. Our patient was the first to exhibit no radicular complaints. The diagnosis was delayed in all four cases and was not determined until the time of surgery. Complete excision offers the best chance for cure, and spinal angiography can aid in diagnosis. However, a high index of suspicion is needed for preoperative detection.
马尾神经肿瘤，特别是终丝肿瘤并不常见。我们报告第四例发生于终丝的成血管细胞瘤。
该35岁男性有4年的腰痛病史，此前被诊断为椎间盘膨出，对其下背部叩诊时有剧痛，但神经功能完好。发现他在L2 - L3水平有一个大的强化肿块占据了硬膜囊。
发现肿瘤附着于终丝，将其完整切除。显微镜下，肿块除了有丰富的充满脂肪的基质细胞和网状组织外，还由内皮细胞组成。
我们给出一份病例报告并对文献进行综述。我们的患者是首例无神经根症状的病例。所有这四例的诊断均被延迟，直到手术时才得以确定。完整切除提供了最佳的治愈机会，脊髓血管造影有助于诊断。然而，术前检测需要高度的怀疑指数。
